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From the earliest days of critical care medicine, the importance of measuring cardiac output and hemodynamic monitoring were recognized in understanding the physiology of critically ill patients. However, methods for measuring cardiac output were cumbersome or not widely available. Ashish K. Khanna, MD, FCCP, FCCM, is joined by Margaret M. Parker, MD, MCCM, to discuss the evolution of the pulmonary artery catheter in critically ill patients, as discussed in “The Story of the Pulmonary Artery Catheter: Five Decades in Critical Care Medicine,” published in Critical Care Medicine.
Can arginine supplements improve the hemodynamics of children with severe pain or acute chest syndrome (ACS) related to sickle cell anemia? Although mortality rates in children with sickle cell disease (SCD) have improved over the past decade, ACS and vasoocclusive episodes (VOE) remain relatively common diagnoses in pediatric ICUs. This Concise Critical Appraisal explores an article in which Onalo et al completed the second phase of their work determining the role that L-arginine treatment may play in the cardiopulmonary status of children with SCD and VOE, with or without ACS. In the first phase of their work, the authors demonstrated decreased hospitalization time, decreased opioid use, and the absence of serious adverse events in children with SCD after receiving L-arginine therapy.
Arno Zaritsky, MD, discusses an article he and Dr. Ikram Haque published in the March 2007 issue of Pediatric Critical Care Medicine titled "Analysis of the Evidence for Lower Limit of Systolic and Mean Arterial Pressure in Children."
Ranjit Deshpande, MD, speaks with Laurence W. Busse, MD, MBA, about Dr. Busse’s talk on preserving end-organ perfusion presented at the 46th Critical Care Congress in Honolulu, Hawaii, USA.
Review how to best utilize parameters provided by minimally invasive advanced hemodynamic monitors.